Is there preliminary value to a within- and/or between-session change for determining short-term outcomes of manual therapy on mechanical neck pain? (original) (raw)
Related papers
Journal of Manipulative and Physiological Therapeutics, 2007
This study provides a systematic analysis of group change scores in randomized clinical trials of chronic neck pain not due to whiplash and not including headache or arm pain treated with manual therapy. A comprehensive literature search of clinical trials of chronic neck pain treated with manual therapies up to December 2005. Only clinical trials scoring above 11.5 (Amsterdam-Maastricht Scale) were included in the analysis. From 1980 citations, 19 publications were selected. Of the 16 trials analyzed (3 were rejected for poor quality), 9 involved spinal manipulation (12 groups), 5 trials (5 groups) were for spinal mobilization or nonmanipulative manual therapy (1 trial overlapped), and 2 trials (2 groups) involved massage therapy. No trials included trigger point therapy or manual traction of the neck. For manipulation studies, the mean effect size (ES) at 6 weeks for 7 trials (10 groups) was 1.63 (95% confidence interval [CI], 1.13-2.13); 1.56 (95% CI, 0.73-2.39) at 12 weeks for 4 trials (5 groups); 1.22 (95% CI, 0.38-2.06) from 52 to 104 weeks for 2 trials (2 groups). For mobilization studies, 1 trial reported an ES of 2.5 at 6 weeks, 2 trials reported full recovery in 63.8% to 71.7% of subjects at 7 to 52 weeks, and 1 trial reported greater than 2/10 point pain score reduction in 78.3% of subjects at 4 weeks. For massage studies, 1 reported an ES of 0.03 at 6 weeks, whereas the other reported mean change scores of 7.89/100 and 14.4/100 at 1 and 12 weeks of, respectively. There is moderate- to high-quality evidence that subjects with chronic neck pain not due to whiplash and without arm pain and headaches show clinically important improvements from a course of spinal manipulation or mobilization at 6, 12, and up to 104 weeks posttreatment. The current evidence does not support a similar level of benefit from massage.
Chiropractic & manual therapies, 2017
Manual therapy according to the School of Manual Therapy Utrecht (MTU) is a specific type of passive manual joint mobilization. MTU has not yet been systematically compared to other manual therapies and physical therapy. In this study the effectiveness of MTU is compared to physical therapy, particularly active exercise therapy (PT) in patients with non-specific neck pain. Patients neck pain, aged between 18-70 years, were included in a pragmatic randomized controlled trial with a one-year follow-up. Primary outcome measures were global perceived effect and functioning (Neck Disability Index), the secondary outcome was pain intensity (Numeric Rating Scale for Pain). Outcomes were measured at 3, 7, 13, 26 and 52 weeks. Multilevel analyses (intention-to-treat) were the primary analyses for overall between-group differences. Additional to the primary and secondary outcomes the number of treatment sessions of the MTU group and PT group was analyzed. Data were collected from September 20...
Clinical Rehabilitation, 2019
Objective: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). Design: Randomized controlled trial. Setting: Outpatient care units. Subjects: Sixty-four non-specific CNP patients were randomly allocated to MET ( n = 32) or UC ( n = 32) groups. Interventions: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. Main measures: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. Results: Fifty-eight participants completed the study....
BMC Musculoskeletal Disorders, 2010
Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU) has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum) till one year (maximum) will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy), also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE) and functional status (Neck Disability Index (NDI-DV)). Secondary outcomes are neck pain (Numeric Rating Scale (NRS)), Eurocol, costs and quality of life (SF36). Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843
Manual Therapy, 2014
Our purpose was to compare the effectiveness of three manual therapy techniques: high velocity, low amplitude (HVLA), mobilization (Mob) and sustained natural apophyseal glide (SNAG) in patients with chronic neck pain (CNP). The randomized controlled trial included patients with mechanically reproducible CNP, who were randomized to the treatment group. Outcome measures were the Visual Analogue scale (VAS), Neck Disability Index (NDI), Global Rating of Change (GROC) and Cervical Range of Motion (CROM). Two-way repeated measures analysis of variance compared outcomes at baseline, at the end of treatment and 1, 2 and 3 months after treatment. A total of 51 subjects completed the trial. No significant differences were found between HVLA, Mob and SNAG at the end of treatment and during the follow-up in any of the analysed outcomes. There were no differences in satisfaction for all techniques. The results lead to the conclusion that there is no long-term difference between the application of HVLA, Mob and SNAG in pain, disability and cervical range of motion for patients with CNP.
Journal of Manipulative and Physiological Therapeutics, 2019
Objectives: The purpose of this study was to describe the design and baseline measurements of a prospective multicenter cohort study in patients with neck pain treated by Dutch manual therapists. Objectives of the study were to determine which patients seek help from a manual therapist, to describe usual care manual therapy in patients with neck pain, to examine the occurrence of nonserious adverse events after treatment, to describe predictors of adverse events, and to determine whether the occurrence of nonserious adverse events affect outcome after manual therapy care. Methods: During a 3-month inclusion period, consecutive patients aged between 18 and 80 years presenting with neck pain in manual therapy practices in The Netherlands were included in the study. Baseline questionnaires included the Numeric Rating Scale, Neck Disability Index (NDI), Neck Bournemouth Questionnaire, Fear Avoidance Beliefs Questionnaire (FABQ), and Patient Expectancy List. Within the treatment episode, manual therapist clinical reasoning and applied interventions were registered and patients reported on adverse events. At the end of the treatment episode and at 12-month follow-up, pain intensity (Numeric Rating Scale), functional outcomes (NDI, Neck Bournemouth Questionnaire), personal factors (FABQ), and global perceived effect were measured. Results: During the 3-month inclusion period, 263 participating manual therapists collected data on 1193 patients with neck pain. Most patients (69.4%) were female. The mean age was 44.7 (±13.7) years. The NDI showed overall mild disability (mean score 26%). Mean scores in pain intensity were moderate (4.8), and there was low risk of prolonged disability owing to personal factors (FABQ). Conclusion: This study provides information on baseline characteristics of patients visiting manual therapists for neck pain. In The Netherlands, patients seeking care of manual therapists are comparable to patients in other countries regarding demographics and neck pain characteristics.
The effectiveness of manual therapy for neck pain: a systematic review of the literature
Physical Therapy Reviews, 2007
Study design: A systematic review of randomised controlled trials. Objective: To determine the effectiveness of manual therapy for mechanical neck disorders in reducing pain and disability in adult populations. Summary of background data: Neck pain is a common ailment that can result in pain, disability and considerable cost. Manual therapy is a treatment modality commonly sought by patients to manage neck pain. Methods: A literature search of MEDLINE, CENTRAL, CINHAL, SPORTdiscus, PEDro and MANTIS was conducted. Articles were included if manual therapy was performed on one group within the trial, on participants with mechanical neck pain, including neck disorders with associated headache. Studies were excluded if the cause of neck pain was serious pathology, systemic disease, or trauma, or if neck pain was associated with radicular findings, or the headache was the primary disorder. Results: Five trials involving 995 participants were included; four of the trials were of high methodological quality according to the validated Jadad criteria. Due to the heterogeneity of the data from the included trials the studies could not be pooled for meta-analysis and, therefore, a qualitative analysis was performed. There was strong evidence suggesting greatest patient satisfaction with care when manual therapy treatment is included as part of the care regimen. There was a trend in three of the studies that when manual therapy was combined with exercise there were greater improvements across pain, disability and patientperceived recovery compared with manual therapy alone, although there were no statistically significant differences between groups. Conclusions: Although there is strong evidence showing no statistically significant differences in the effectiveness of manual therapy compared with other interventions 4 (exercise, physical therapy, medication, short wave diathermy), patients receiving manual therapy were significantly more satisfied with their care than patients in any other group. Better results are demonstrated when manual therapy is combined with exercise although these results are not statistically significant, suggesting that multi-modal care including manual therapy and exercise may be a potentially useful intervention in the treatment of mechanical neck disorders.
The effect of manual therapy with augmentative exercises for neck pain: a randomised clinical trial
Journal of Manual & Manipulative Therapy, 2015
Objectives: To compare the effect of manual therapy (MT) and an augmentative exercise programme (AEP) versus MT and general neck range of motion (ROM) on functional outcomes for patients with neck pain. A secondary objective was to examine changes in self-report measures and quantitative sensory testing (QST) following MT and AEP. Methods: This was a randomised clinical trial. Seventy-two patients with neck pain were recruited. All patients received a single session of MT. Patients were randomly assigned to MT+AEP or MT+ROM. Clinical self-report outcome measures for disability and pain, and QST measures (pain and vibration thresholds) were collected at baseline, post MT treatment, at ∼48 hours, and at ∼96 hours. Repeated measures ANOVA and MANOVA were used to analyse within and between-group effects for clinical and QST measures. Results: There were no between-group differences for disability, pain and QST measures. There was, however, a significant difference between groups for Global Rating of Change (GRoC) scores (P = 0.037). Patients in both groups showed improvements in pain, disability and trapezius pressure-pain threshold (PPT) (all P < 0.001). Discussion: Augmentative exercise programme does not significantly improve disability, pain or QST measures in patients with chronic neck pain although it may enhance their GRoC scores. Over a 96-hour period, patients benefitted from MT plus exercise whether the exercise was general or specific.
Efficacy of Manual Therapy in Neck Pain: A Review
Background: Neck pain (NP) is a significant contributor to worldwide disability and poses a considerable financial burden to its stakeholders. Prognosis for chronic neck pain is generally poor, and the associated disability seems to be more persistent than low back pain. 66% of the population will suffer from neck pain at some point during their lifetime. More than one-third of people affected still have low grade symptoms or recurrences more than one year after treatment, often leading to chronic pain. More than one-third of those affected also show signs of mild pain or recurrence after 12 months of management, usually contributing to chronic pain. Different manual therapy methods and strategies exist; a common aspect is the use of hands during therapy which involves both manipulation and mobilization. Aim: To determine the recent research evidences for the efficacy of manual therapy in neck pain patients. Method: This review mainly includes randomized controlled trails (RCTs). Searching done by Google scholar, Pub med and Pedro from 2010 to 2019. We used terms like-neck pain, mobilization, manipulation, exercise and physiotherapy management. Result: Present outcomes shows that manual therapy treatment is effective technique in reducing pain and increasing Range of motion (ROM) in neck pain patients without adverse effects. The search resulted in 150 articles but only 10 articles were selected for the study based on criteria. Conclusion: Manual therapy program designed for neck pain treatment can be more effective at increasing neck ROM and reducing pain.